{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T02:06:49Z","timestamp":1771553209959,"version":"3.50.1"},"reference-count":69,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Childhood cancer impacts the entire family unit. We sought to investigate its impact on the long\u2010term physical health outcomes of siblings of children with cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Pediatric cancer patients diagnosed in Ontario, Canada between 1988 and 2016 were linked to biological siblings. Sibling cases were matched to population controls based on sex, age, geographic location, and number of other children in the family. After individual linkage to health services data, we compared several outcomes between sibling cases and controls: (a) physical health conditions (such as diabetes, hypertension, and death); (b) acute health care use (hospitalization, low\u2010 and high\u2010acuity emergency department [ED] visits); and (c) preventive health care use (periodic health checkups, influenza vaccinations). Cox proportional hazards, recurrent event, or logistic regression models were used as appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 8529 sibling cases and 30,364 matched controls (median age at index: 6\u00a0years, median age at last follow\u2010up 17\u00a0years). Compared to controls, siblings were at increased risk of hypertension (hazard ratio [HR] 1.8; 95% confidence interval [CI] 1.1\u20132.9; <jats:italic>p\u00a0<\/jats:italic>=\u00a0.01), had higher rates of low\u2010 and high\u2010acuity ED visits (rate ratio 1.1; 95% CI 1.1\u20131.2; <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.001), and increased risk of hospitalization (HR 1.1; 95% CI 1.1\u20131.2; <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.001). Sibling cases were also more likely to receive preventive health care (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increased risk of hypertension, high\u2010acuity ED visits, and hospitalizations suggest that siblings may experience poorer health compared to controls. Counseling families about this potential increased risk and long\u2010term follow\u2010up of siblings to monitor their physical health may be justified.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29438","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T07:31:59Z","timestamp":1637134319000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Morbidity and health care use among siblings of children with cancer: A population\u2010based study"],"prefix":"10.1002","volume":"69","author":[{"given":"Aditi","family":"Desai","sequence":"first","affiliation":[{"name":"Institute of Medical Science University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rinku","family":"Sutradhar","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy","family":"Lau","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas S.","family":"Lee","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"},{"name":"Peter Munk Cardiac Centre University Health Network  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-0871","authenticated-orcid":false,"given":"Paul C.","family":"Nathan","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children Division of Haematology\/Oncology  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1334-3670","authenticated-orcid":false,"given":"Sumit","family":"Gupta","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children Division of Haematology\/Oncology  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,16]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","first-page":"394","article-title":"Meeting the needs of siblings of children with cancer","volume":"30","author":"Ballard KL","year":"2004","journal-title":"Pediatr Nurs"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-015-2716-7"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21056"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.761"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2016.06.005"},{"issue":"9","key":"e_1_2_10_7_1","first-page":"588","article-title":"Children with cancer: the needs of siblings","volume":"11","author":"Harding R","year":"1996","journal-title":"Prof Nurse"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950130403"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.01382"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199608)27:2<98::AID-MPO6>3.0.CO;2-O"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-015-1213-9"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-11-1095"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2009.09.020"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05838-X"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11004"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081070"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000337"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.121283"},{"key":"e_1_2_10_19_1","unstructured":"Ontario Cancer Registry.Cancer Care Ontario.https:\/\/www.cancercareontario.ca\/en\/cancer\u2010care\u2010ontario\/programs\/data\u2010research\/ontario\u2010cancer\u2010registry. 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